Association between patient beliefs and medication adherence following hospitalization for acute coronary syndrome

LaPointe, Nancy M. Allen; Ou, Fang Shu; Calvert, Sara B.; Melloni, Chiara; Stafford, Judith A.; Harding, Tina; Peterson, Eric D.; Alexander, Karen P.

doi:10.1016/j.ahj.2011.02.009

Cited by 56 publications

(51 citation statements)

References 21 publications

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“…Finally, we used a theoretical construct to examine factors associated with medication adherence. Most other investigations have focused on clinical factors and did not measure participants' beliefs and attitudes, which may be important predictors of adherence (38,39).…”

Section: Discussionmentioning

confidence: 99%

Relationship between Adherence to Oral Antibiotics and Postdischarge Clinical Outcomes among Patients Hospitalized with Staphylococcus aureus Skin Infections

Eells

Nguyen

Jung

et al. 2016

Antimicrob Agents Chemother

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e Skin and soft tissue infections are common and frequently recur. Poor adherence to antibiotic therapy may lead to suboptimal clinical outcomes. However, adherence to oral antibiotic therapy for skin and soft tissue infections and its relationship to clinical outcomes have not been examined. We enrolled adult patients hospitalized with uncomplicated skin and soft tissue infections caused by Staphylococcus aureus who were being discharged with oral antibiotics to complete therapy. We fit the participants' pill bottles with an electronic bottle cap that recorded each pill bottle opening, administered an in-person standardized questionnaire at enrollment, 14 days, and 30 days, and reviewed the participants' medical records to determine outcomes. Our primary outcome was poor clinical response, defined as a change in antibiotic therapy, new incision-and-drainage procedure, or new skin infection within 30 days of hospital discharge. Of our 188 participants, 87 had complete data available for analysis. Among these participants, 40 (46%) had a poor clinical response at 30 days. The mean electronically measured adherence to antibiotic therapy was significantly different than the self-reported adherence (57% versus 96%; P < 0.0001). In a multivariable model, poor clinical response at 30 days was associated with patients having lower adherence, being nondiabetic, and reporting a lack of illicit drug use within the previous 12 months (P < 0.05). In conclusion, we found that patient adherence to oral antibiotic therapy for a skin and soft tissue infection after hospital discharge was low (57%) and associated with poor clinical outcome. Patients commonly overstate their medication adherence, which may make identification of patients at risk for nonadherence and poor outcomes challenging. Further studies are needed to improve postdischarge antibiotic adherence after skin and soft tissue infections. Skin infections are a common reason for physician visits and hospital admission (1, 2). Staphylococcus aureus is the most common cause of skin infections in the community (3, 4). Recurrent and/or relapse skin infections are commonly reported after an initial S. aureus skin infection (5-7). Rates of recurrence have exceeded 50% in some populations (5,8,9).Reasons for the failure of a skin infection to resolve are poorly understood but are likely to be due to host and behavior factors, inadequate medical and/or surgical therapy, and possibly pathogen-associated factors (10). In other chronic and acute infections, medication adherence is frequently suboptimal and associated with worse clinical outcomes (11-13). However, there are no studies to date evaluating antibiotic adherence, or the relationship between adherence and clinical outcome, among patients experiencing skin infections.Poor adherence to medication regimens is common across all disease entities. Low adherence contributes to a worsening of the patient's condition, death, and increased health care costs (14). Even in clinical trials, where study participants receive increas...

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Section: Discussionmentioning

confidence: 99%

Relationship between Adherence to Oral Antibiotics and Postdischarge Clinical Outcomes among Patients Hospitalized with Staphylococcus aureus Skin Infections

Eells

Nguyen

Jung

et al. 2016

Antimicrob Agents Chemother

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“…The most common measures used for assessing medication adherence were proportion of days covered (PDC) (n ¼ 9), 24,26,27,29,30,33,35,37,38 followed by medication possession ratio (MPR) (n ¼ 5), 23,25,31,32,34 electronic medication monitors (n ¼ 1), 36 and self-reported data (n ¼ 1). 28 Twelve studies 23,26,27,29e33,35e38 defined good adherence to prescribed medication using a percentage cut-off at 80%, while two studies 24,25 used a cut-off at 75%. One study did not report a cut point of good adherence.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The remaining 2 studies 28,36 reported on samples of patients with an ACS recruited from hospital-based settings, which were all prospective cohort studies. Seven of the articles included were USbased studies 23,25,28,31,33,34,36 and the non-US studies (n ¼ 9) were from Canada 27,35,38 and several European countries (i.e., UK, 37 Italy, 29,30 Spain, 24 France 26,32 ) with universal health coverage. Overall, 14 studies 23e27,29e35,37,38 used claims-based data to estimate medication adherence.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Overall, 14 studies 23e27,29e35,37,38 used claims-based data to estimate medication adherence. The remaining 2 studies used data from telephone surveys 28 Nine studies 23,24,26,30,31,33,34,36,37 provided information about the average age of their study sample, which ranged from 50 to 80 years. The majority of participants in our included studies was white, though only 3 US-based studies 25,33,36 provided data on race/ ethnicity.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Adherence to evidence-based secondary prevention pharmacotherapy in patients after an acute coronary syndrome: A systematic review

et al. 2015

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“…26 Internal consistency reliabilities for the specific-necessity and specificconcerns subscales, as measured by Cronbach's ! values, have been reported in samples with HF (.67 and .81).…”

Section: Measurementmentioning

confidence: 99%

Illness Representations, Treatment Beliefs, Medication Adherence, and 30-Day Hospital Readmission in Adults With Chronic Heart Failure

Turrise

2016

Journal of Cardiovascular Nursing

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Nurses can use these study findings to help identify individuals who may be at risk of being nonadherent to their medications and hospital readmission. Recommendations for future research include replication with multiple sites, the addition of objective measures of medication adherence, investigation of both the cognitive and emotional pathways, and qualitative exploration of personal control in the context of medication adherence in HF.

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Association between patient beliefs and medication adherence following hospitalization for acute coronary syndrome

Cited by 56 publications

References 21 publications

Relationship between Adherence to Oral Antibiotics and Postdischarge Clinical Outcomes among Patients Hospitalized with Staphylococcus aureus Skin Infections

Relationship between Adherence to Oral Antibiotics and Postdischarge Clinical Outcomes among Patients Hospitalized with Staphylococcus aureus Skin Infections

Adherence to evidence-based secondary prevention pharmacotherapy in patients after an acute coronary syndrome: A systematic review

Illness Representations, Treatment Beliefs, Medication Adherence, and 30-Day Hospital Readmission in Adults With Chronic Heart Failure

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